MR. MARK MITCHELL ROUBIDOUX II (NPI# 1629685235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629685235 |
Entity Type | Individual |
Full Name | MR. MARK MITCHELL ROUBIDOUX II |
Practice Address |
201 18th Ave Lewiston ID 83501-2768 |
Practice Telephone | 2083053537 |
Mailing Telephone | 2083053537 |
Enumeration Date | 2020-09-28 |
Last Update Date | 2020-09-28 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
39235 | ID | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285814186 | Mark Roubidoux | Nurse Anesthetist, Certified Registered | 1221 Highland Ave, Clarkston, WA 99403-2829 | 2007-11-07 |
Street Address |
201 18TH AVE |
City | LEWISTON |
State | ID |
Zip Code | 83501-2768 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679193759 | Jacqueline M Aldrich | Behavior Technician | 3407 12th Street C, 3407 12th Street C, Lewiston, ID 83501 | 2020-04-20 |
1295228054 | Provident Foundation - Wedgewood Terrace LLC | Alzheimer Center (Dementia Center) | 2114 Vineyard Avenue, Lewiston, ID 83501 | 2018-06-07 |
1164945325 | Xiaofei Liu | Massage Therapist | 234 Thain Rd, Lewiston, ID 83501 | 2017-07-19 |
1467909879 | Sharon Thulon | Registered Nurse | 1118 F Street, Lewiston, ID 83501 | 2016-09-01 |
1821459496 | Gem State Endoscopy | Clinic/Center | 3709 14th Street, Lewiston, ID 83501 | 2016-03-10 |
1508264995 | Gary L. Grogan | Psychologist | 633 Main Street, B#1, Lewiston, ID 83501 | 2014-12-17 |
1003189366 | John Joseph Johnson | Dentist | 3510 12th Street, Suite #600, Lewiston, ID 83501 | 2012-02-17 |
1306134077 | Rowena Kathryn Jackson | Counselor | 531 Bryden Avenue, Lewiston, ID 83501 | 2011-07-15 |
1912290388 | Staci Leanne Truby | Massage Therapist | 717 'd' Street, Lewiston, ID 83501 | 2011-05-18 |
1093040685 | Sharie Ann Uhlorn | Registered Nurse | 1837 Alder Court, Lewiston, ID 83501 | 2009-10-15 |
Find all providers in zip 83501 |
Taxonomy Code | 363LA2100X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Acute Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700359544 | Marcello Romeo | Nurse Practitioner | 300 Main St, Lewiston, ME 04240-7027 | 2019-01-04 |
1710343777 | Patricia Rand | Nurse Practitioner | 93 Campus Ave, Lewiston, ME 04240-6030 | 2016-01-06 |
1619241908 | Scott Andrew Smith | Nurse Practitioner | 300 Main St, Lewiston, ME 04240-7027 | 2012-03-04 |
1194714568 | Vera J Komisarjevsky | Nurse Practitioner | 93 Campus Ave, Lewiston, ME 04240-6030 | 2005-10-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275199663 | Jason T Elliott | Nurse Practitioner | 12094 N Barn Owl Way, Boise, ID 83714-1363 | 2019-05-12 |
1699055491 | Nicole Dawn Bartlett | Nurse Practitioner | 243 Cheney Dr W Ste 200, Twin Falls, ID 83301-4278 | 2011-08-24 |
1174707442 | Tracy K Matalon | Nurse Practitioner | 3340 E Goldstone Way, Meridian, ID 83642-1026 | 2007-12-21 |
1639364482 | Saint Alphonsus Specialty Services Inc | Nurse Practitioner | 660 E Boise Ave, Boise, ID 83706-5118 | 2007-09-13 |
1780879536 | Saint Alphonsus Specialty Services Inc | Nurse Practitioner | 2809 Cleveland Blvd, Caldwell, ID 83605-4443 | 2007-09-13 |
1962522409 | Wendy Swope | Nurse Practitioner | 3388 Highway 26, Irwin, ID 83428 | 2007-03-29 |
1609808328 | Nancy Nuce Taylor | Nurse Practitioner | 3525 E Louise Dr Ste 500, Meridian, ID 83642-6305 | 2006-07-06 |
1336193598 | Angela K. Hughes | Nurse Practitioner | 6933 W Emerald St, Boise, ID 83704-8616 | 2006-05-20 |
1174156962 | Rachel Lynne Davis | Nurse Practitioner | 190 E Bannock St, Boise, ID 83712-6241 | 2020-02-20 |
1205489978 | Kimereng Kipchumba Kipsuge | Nurse Practitioner | 1717 Arlington Ave, Caldwell, ID 83605-4802 | 2019-07-22 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.